外固定架结合有限内固定治疗复杂跟骨骨折
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作者Author单位AddressE-Mail
李明辉 LI Ming-hui 武汉市第五医院骨科,湖北 武汉 430050 Department of Orthopaedics,the Fifth Hospital of Wuhan,Wuhan 430050,Hubei,China lmh061127@163.com 
刘洋 LIU Yang 武汉市第五医院骨科,湖北 武汉 430050 Department of Orthopaedics,the Fifth Hospital of Wuhan,Wuhan 430050,Hubei,China  
期刊信息:《中国骨伤》2010年,第23卷,第3期,第217-219页
DOI:10.3969/j.issn.1003-0034.2010.03.022
基金项目:
中文摘要:

目的:观察调节式外固定支架结合普通螺钉、克氏针等有限内固定方法治疗复杂跟骨骨折(SandersⅢ、Ⅳ型)的临床疗效。

方法:自2003年1月至2008年6月采用外固定支架结合普通螺钉、克氏针等有限内固定方法治疗27例36足(左侧19足,右侧17足)SandersⅢ、Ⅳ型复杂跟骨骨折患者(年龄17~65岁,平均37岁),患足术前均行X线及CT检查,并按Crosby-Fitzgibbons-Sanders分类法进行分组, 术后B?觟hler角和Gissane角的改变采用X线片进行分析,功能状况采用张铁良跟骨骨折综合评分法进行评定。

结果:36足中32足获得随访,时间为11~24个月,平均13个月,B?觟hler角和Gissane角分别由术前平均(8.0±7.3)°及(130.5±10.5)°,恢复到术后平均(29.6±7.4)°及(122.5±8.6)°。采用张铁良跟骨骨折综合评分法评为优17足,良8足,中5足,差2足。3足因手术发生伤口感染或皮缘坏死,经负压封闭引流术或伤口换药后获得愈合。

结论:外固定架结合有限内固定治疗复杂跟骨骨折具有并发症少、功能恢复好等优点,能有效治疗复杂跟骨骨折。
【关键词】跟骨  骨折  外固定器  骨折固定术,内
 
Treatment of complex calcaneal fractures with external fixator and limited internal fixation
ABSTRACT  

Objective: To study the clinical effects of the adjustable external fixation combined with the limited internal fixation such as ordinary screws,Kirschner wire fixation for the treatment of complex calcaneal fractures(SandersⅢ,Ⅳ).

Methods: From January 2003 to June 2008,27 patients 36 feet(19 feet in the left and 17 feet in the right) with calcaneal fractures of Sanders Ⅲ and Ⅳ(the age ranged from 17 to 65 years,mean 37 years)were treated with external fixator combined with ordinary screws and Kirschner wire fixation. All the patients were undergone X-ray and CT examinations and classified by Crosby-Fitzgibbons-Sanders. The changes of the B?觟hler and Gissane angles were analyzed by X-ray. The functional of the feet was assessed by ZHANG Tie-liang calcaneal fractures scoring system.

Results: Thirty-two feet were followed up for 11 to 24 months,with an average of 13 months. The B?觟hler and Gissane angles changed from average(8.0±7.3) degree and(130.5±10.5) degree,back to postoperative(29.6±7.4) degree and (122.5±8.6) degree. According to ZHANG Tie-liang scoring system,the result was excellent in 17 feet,good in 8 feet,fair in 5 feet and not satisfied with 2 feet. Three feet with wound infection or skin flap necrosis were healed after vacuum sealing drainage or wound dressing.

Conclusion: The combination of external fixator and limited internal fixation is an effective treatment for complex calcaneal fractures with few complications and good functional recovery.
KEY WORDS  Calcaneus  Fractures  External fixators  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:李明辉,刘洋.外固定架结合有限内固定治疗复杂跟骨骨折[J].中国骨伤,2010,23(3):217~219
英文格式:LI Ming-hui,LIU Yang.Treatment of complex calcaneal fractures with external fixator and limited internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(3):217~219
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